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State seeks E. coli link in death of Pasco girl

The girl, one of seven unconfirmed cases, attended one of two fairs suspected of making 14 others ill.

By DONG-PHUONG NGUYEN
Published March 29, 2005

TAMPA - State health officials said Monday that they are looking into a possible link between the death of a 12-year-old Pasco County girl and E. coli outbreaks at two state fairs.

Officials have confirmed 14 cases of E. coli across the state. Kayla Nicole Sutter, who died last week, is among seven suspected cases of E. coli that are still unconfirmed, said Florida Health Secretary John Agwunobi.

Sutter, a student at Weightman Middle School in Wesley Chapel, is the only reported death so far. Her family told a Pasco epidemiologist that she had visited the petting zoo at the Florida Strawberry Festival.

The 14 confirmed cases involve 12 children and two adults who all share three common threads: They all had attended either the Strawberry Festival in Plant City or the Central Florida Fair in Orlando; all had diarrhea within the past two to three weeks; and all tested positive for a specific strain of E. coli , or showed signs of having hemolytic uremic syndrome, or HUS, a fairly infrequent kidney disease that sometimes results from E. coli .

Pasco County health officials on Saturday said an 8-year-old girl is the county's lone confirmed case of HUS.

Sutter is among seven cases being investigated for a possible link to E. coli . The remaining six are from Seminole, Taylor, Highlands and Orange counties.

Agwunobi called Sutter's death "tragic."

"Until the medical examiner provides us with more detail, at this point, it remains one of our suspect cases," he said.

The number of confirmed cases dropped from 15 to 14 over the weekend after further lab testing negated a once-positive result, Agwunobi said.

Health officials are trying to pinpoint a common point of contact.

The affected people could have eaten undercooked beef, or they may have touched animals with that particular strain of E. coli during fair-related activities such as petting goats, riding a pony, milking a cow or racing pigs.

"I don't want people to think, "I was at the fair, but I didn't go to the petting zoo,"' Agwunobi said. "Walking through an area where animals have deposited waste contaminates the shoes you wear."

Once the bacteria enters the body, the incubation period is three to 10 days. Diarrhea will occur. About 8 percent of the cases progress to HUS, leading to kidney malfunction, he said. The mortality rate for HUS cases is 3 to 5 percent.

It can become a severe and debilitating illness, frequently requiring admission to a hospital and, in some cases, intensive care and dialysis.

The Florida Department of Agriculture has been testing animals from both fairs. Of the several hundred to be tested, 37 samples so far have come back positive for some strain of E. coli , which is very common, said spokeswoman Liz Compton.

"It's completely natural and not uncommon at all," she said. "We expected that."

Samples testing positive for E. coli will undergo further testing to see whether it is the particular strain that is afflicting the ill people. Then DNA testing follows, Compton said.

Agwunobi once again reiterated the need to practice good hygiene.

"Wash your hands diligently, frequently and often," he said. "The bottom line is, that's the key to prevention."